Quantitative evaluation of calcaneofibular ligament injury on the oblique coronal view of magnetic resonance imaging in chronic lateral ankle instability

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science Pub Date : 2024-11-01 DOI:10.1016/j.jos.2023.10.008

Akinori Nekomoto , Tomoyuki Nakasa , Yasunari Ikuta , Yasuteru Shimamura , Naoyuki Kitamura , Junichi Sumii , Shingo Kawabata , Nobuo Adachi

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引用次数: 0

Abstract

Background

In the treatment of chronic lateral ankle instability (CLAI), the repair of the calcaneofibular ligament (CFL) and anterior talofibular ligament (ATFL) is still being discussed, possibly due to the difficulty in assessing CFL injuries. In particular, it is challenging to evaluate the extent of CFL deficiency quantitively. We hypothesized that CFL tension change would alter morphology of the CFL on magnetic resonance imaging (MRI) and that measuring this morphological change allows assessing CFL injury quantitatively. Thus, this study aimed to analyze the feasibility of quantitatively assessing CFL injuries using MRI.

Methods

Sixty-four ankles with CLAI were included and divided into two groups: with (ATFL and CFL group, 31 ankles) or without CFL repair (ATFL group, 33 ankles) in addition to arthroscopic ATFL repair. The angle between the CFL and calcaneal axis (CFLCA) and the bending angles of the CFL was defined as the flexed CFL angle (FCA) were measured on the oblique CFL view of preoperative MRI. The diagnostic abilities of these angles for CFL injury and correlations between these angles and stress radiographs were analyzed.

Results

The sensitivity and specificity of CFLCA were 86.7 % and 88.7 %, and those of FCA were 63.3 % and 77.4 %, respectively. The combination of CFLCA and FCA improved the sensitivity to 93.3 %. The cutoff points of CFLCA and FCA were 3.8° and 121.2°, respectively. There were significant moderate and weak correlations between the talar tilting angle and CFLCA or FCA (rs = −0.533, and rs = −0.402, respectively). The CFLCA and FCA were significantly smaller in the ATFL and CFL group than those in the other groups.

Conclusions

Measurement of CFLCA and FCA in oblique CFL view on MRI could be useful for the quantitative evaluation of CFL injury in patients with CLAI．

Level of evidence

Level IV. case-control study.

查看原文本刊更多论文

磁共振成像对慢性踝关节外侧不稳定患者跟骨腓韧带损伤的冠状斜位定量评价。

背景：在治疗慢性踝关节外侧不稳定（CLAI）的过程中，跟骨腓韧带（CFL）和距腓前韧带（ATFL）的修复仍在讨论中，可能是因为难以评估CFL损伤。特别是，定量评估CFL缺乏的程度具有挑战性。我们假设CFL张力的变化会改变磁共振成像（MRI）上CFL的形态，测量这种形态变化可以定量评估CFL损伤。因此，本研究旨在分析使用MRI定量评估CFL损伤的可行性。方法：64个患有CLAI的脚踝被纳入并分为两组：除了关节镜下的ATFL修复外，还进行了（ATFL和CFL组，31个脚踝）或不进行CFL修复（ATFL组，33个脚踝）。在术前MRI的CFL斜视图上测量CFL与跟骨轴之间的角度（CFLCA）和CFL的弯曲角度定义为弯曲CFL角度（FCA）。分析了这些角度对CFL损伤的诊断能力以及这些角度与应力片之间的相关性。结果：CFLCA的敏感性和特异性分别为86.7%和88.7%，FCA的敏感性和特异度分别为63.3%和77.4%。CFLCA和FCA的组合将灵敏度提高到93.3%。CFLCA的截止点和FCA的截止点分别为3.8°和121.2°。距骨倾斜角与CFLCA或FCA之间存在显著的中等和弱相关性（分别为rs=-0.533和rs=-0.402）。ATFL和CFL组的CFLCA和FCA明显小于其他组。结论：MRI斜方CFL视野下CFLCA和FCA的测量可用于CLAI患者CFL损伤的定量评估。证据水平：IV级病例对照研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Orthopaedic Science 医学-整形外科

CiteScore

3.00

自引率

0.00%

发文量

290

审稿时长

90 days

期刊介绍： The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.